A prospective study of the natural history of large local reactions after Hymenoptera stings in children

Graft, David F.; Schuberth, Kenneth C.; Kagey‐Sobotka, Anne; Kwiterovich, Kathy A.; Niv, Yaffa; Lichtenstein, Lawrence M.; Valentine, Martin D.

doi:10.1016/s0022-3476(84)80940-3

Cited by 99 publications

(47 citation statements)

References 13 publications

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“…The risk for future systemic reactions is low in patients with LLR, in whom only 0.8%-7% are expected to develop SSR in the future. [14][15][16] As patients with repeated LLRs have been reported to have a minimal risk for SSR, 17,18 VIT is generally not recommended in these patients. However, subcutaneous VIT has been shown to reduce the size and duration of LLR.…”

Section: Editorial Independence and Managing Conflict Of Interestsmentioning

confidence: 99%

EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy

Sturm

Varga

Roberts

et al. 2017

Allergy

395

528

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Hymenoptera venom allergy is a potentially life‐threatening allergic reaction following a honeybee, vespid, or ant sting. Systemic‐allergic sting reactions have been reported in up to 7.5% of adults and up to 3.4% of children. They can be mild and restricted to the skin or moderate to severe with a risk of life‐threatening anaphylaxis. Patients should carry an emergency kit containing an adrenaline autoinjector, H1‐antihistamines, and corticosteroids depending on the severity of their previous sting reaction(s). The only treatment to prevent further systemic sting reactions is venom immunotherapy. This guideline has been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Taskforce on Venom Immunotherapy as part of the EAACI Guidelines on Allergen Immunotherapy initiative. The guideline aims to provide evidence‐based recommendations for the use of venom immunotherapy, has been informed by a formal systematic review and meta‐analysis and produced using the Appraisal of Guidelines for Research and Evaluation (AGREE II) approach. The process included representation from a range of stakeholders. Venom immunotherapy is indicated in venom‐allergic children and adults to prevent further moderate‐to‐severe systemic sting reactions. Venom immunotherapy is also recommended in adults with only generalized skin reactions as it results in significant improvements in quality of life compared to carrying an adrenaline autoinjector. This guideline aims to give practical advice on performing venom immunotherapy. Key sections cover general considerations before initiating venom immunotherapy, evidence‐based clinical recommendations, risk factors for adverse events and for relapse of systemic sting reaction, and a summary of gaps in the evidence.

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Section: Editorial Independence and Managing Conflict Of Interestsmentioning

confidence: 99%

EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy

Sturm

Varga

Roberts

et al. 2017

Allergy

395

528

View full text Add to dashboard Cite

show abstract

“…11,26,28 Adults and children who have had large local reactions to stings have a 4% to 10% chance of future systemic reactions, which is (inexplicably) less than the 17% frequency reported in individuals with asymptomatic sensitization. 26,32,35,36 The variability in reaction rates among patients with positive histories and positive skin test results is shown in Table I.…”

Section: Natural Historymentioning

confidence: 99%

Insect sting allergy and venom immunotherapy: A model and a mystery

Golden¹

2005

Journal of Allergy and Clinical Immunology

166

112

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“…[3][4][5][6][7] The most common reaction is a small local reaction which consists of a painful, pruritic, urticarial lesion usually lasting for only several hours. [2][3][4] Large local reactions are reported for about 10% of patients after a sting.…”

Section: Discussionmentioning

confidence: 99%

“…These reactions consist of edema and erythema greater than 5 cm, they are present for more than 24 hours, and they may persist up to a week. 4,6 Systemic allergic reactions are reported to occur in 0.4%-0.8% of patients. Mild systemic reactions are not life-threatening and consist of cutaneous manifestations such as urticaria, angioedema, erythema, and pruritis.…”

Section: Discussionmentioning

confidence: 99%